Provider Demographics
NPI:1477576726
Name:KOLSKI, TAMMI DEA (MS, LLP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMI
Middle Name:DEA
Last Name:KOLSKI
Suffix:
Gender:F
Credentials:MS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9433 ANNIE LN
Mailing Address - Street 2:
Mailing Address - City:NEWAYGO
Mailing Address - State:MI
Mailing Address - Zip Code:49337-8012
Mailing Address - Country:US
Mailing Address - Phone:231-834-9513
Mailing Address - Fax:231-834-9524
Practice Address - Street 1:9433 ANNIE LN
Practice Address - Street 2:
Practice Address - City:NEWAYGO
Practice Address - State:MI
Practice Address - Zip Code:49337-8012
Practice Address - Country:US
Practice Address - Phone:231-834-9513
Practice Address - Fax:231-834-9524
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007485103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical